Despite a plethora of recommendations for prevention and control of work-related musculoskeletal disorders of the neck and upper limb (WMSD), few systematic evaluations have been made of workplace-based interventions. The proposed study builds upon our previous research with the workplace partners in assessing the impact of a joint labor-management directed program on primary, secondary and tertiary prevention of WMSD among office workers. Qualitative methods will be used to document the nature of interventions and their implementation. The primary comparison will be between self-reported risks for WMSD, symptoms of WMSD and disability associated with WMSD before the program and after 1.5 years of implementation, using a repeat cross-sectional survey. A number of independent measurements of exposures and outcomes will be carried out to increase study validity. Among a group of the workforce undergoing re- organization, with input from ergonomists, changes in physical and psychological exposures will be measured and these measures compared with those of a job-matched control group not experiencing reorganization. Active and passive workplace surveillance systems will be strengthened to monitor changes in risk factors for and severity of WMSD over time. Health outcomes-based monitoring will be implemented on those reporting a WMSD to the workplace. Consent to access secondary data on absenteeism, health care utilization and workers' compensation will be sought from participants to permit estimation of associated costs and to determine if the program results in reduced absenteeism and cost savings compared with prior years. Regular feedback of interim results to the joint labor-management committee will provide opportunities for the adjustment of the interventions. Finally, results from each of the evaluation components will be integrated to provide the workplace parties with an overall evaluation of the effectiveness of the intervention package in reducing the burden of WMSD.